The present invention relates in general to a clinical information system and a method for using it for patient charting or record keeping purposes. The invention more particularly relates to a clinical critical care path system, which facilitates the ability for an improved careful maintenance of patient care.
Charting the progress of a patient after being admitted to a medical care facility for medical or surgical reasons has been a traditional practice in the medical profession. Such charting typically involves monitoring the condition of a patient, collecting information relative to the physical condition of the patient, and logging the collected information onto a patient chart for review and analysis by trained medical personnel.
To make such charting more efficient and cost effective, various monitoring and information gathering systems have been developed to provide automatic clinical record management. For example, reference may be made to the following United States patents and published articles, as follows: U.S. Pat. Nos. 5,361,202; 5,267,155; 5,077,666; 5,072,383; 4,893,270; 4,878,175; 4,838,275; 4,815,474; 4,803,625; 4,731,726; 4,712,562; 4,695,954; 4,674,652; 4,665,499; 4,622,185; 4,577,638; 4,531,527; 4,519,398; 4,513,294; 4,489,387; 4,473,884; 4,465,077; 4,428,381; 4,422,081; 4,417,306; 4,412,292; 4,363,368; 4,347,213; 4,320,766; 4,296,756; 4,272,878; 4,270,547; 4,227,526; 4,216,462; 4,197,854; 4,173,971; 4,151,831; 4,150,284; 4,130,881; 4,004,577; 3,996,928; 3,963,019; 3,910,257; 3,872,448; 3,872,251; 3,830,896; 3,765,406; 3,726,270; 3,696,805; 3,426,150; 3,302,828; 3,106,701; 2,891,111; and 1,078,090; and Walter A. Shewhart, Ph.D., Statistical Method from the View point of Quality Control, (copyright) 1939; pp. 1-49; Donald Del Mar, George Sheldon, Introduction to Quality Control, (copyright) 1988, pp. 123-143; Irvin W. Burr, Statistical Quality Control Methods, (copyright) 1976, pp. 23-35, Indirect Heart Rate Measuring Device, Wilberger, 1994; American J. of Medical Elec., Light Wt. Carbon Fiber Structures . . . , Manley et al., 1973; Composites, Data Communications, November 1986, Principi et al., William Beaumont Hospital and Its Generation System, U.S. Healthcare, Vol. 6, No. 3, March 1998, Childs; Evaluating Automated Information Systems, Mowra et al., Vol.5, No. 1, January/February 1987, Nursing Economics: Automated Information Systems in Quality Assurance, Mowra et al., Nursing Economics, September/October 1987; Doctor Office Manager: An IBM Billing Package, Abstract of Article Appearing in M.D. Computing Vol. 2, No. 3, pp. 23-30, 6/85, Abstract from Microsearch File of Orbit AN85-026189; J. E. Brimm, Computers in Critical Care, March 1987, pp. 53-63, Critical Care Nursing Quarterly, Hewlett Packard, 78707A; PDMS Clinical User""s Guide, January 1982, pp. 1-1 through 1-34, 10-1 through 10-5, 15-1 through 15-2; Hewlett Packard; PDMS System Description, 1982, pp. 1-1 through 2-23; Health Data Science Corp. Ulticare (presumably 10/84), pp. 1-9; Ralph A. Korpman, Patient Care Information Systemsxe2x80x94Looking to the Future, Software in Healthcare, Parts 1-5, April/May 1984-December/January 1984-1985; An Integrated Bedside Fetal Monitor and Obstetrical Data System, IEEE Eng. In. Med. and Biology Med., September 1984, pp. 22-24; and U.S. Healthcare, Vol. 6, No. 3, March 1989, each of the foregoing patents and published articles being incorporated herein by reference as though fully set forth herein.
As disclosed in the foregoing publications, various clinical information systems display, monitor and chart patient physiological conditions. Such systems enable a user to enter information regarding the condition of a patient and to have lists of tasks to be performed regarding a patient to be generated.
While such systems may have been satisfactory for some applications, they have not proven to be entirely satisfactory for some applications relative to improving patient management on a cost effective basis. More particularly, a treatment plan for each new patient would still necessitate suitable preparation, usually by more than one highly trained healthcare provider. Such preparation time, while an important task, has been burdensome and not always efficient and cost effective.
With the rapid rise in medical treatment costs and hospitalization costs, it has become very important to be more efficient to achieve overall cost saving reductions. To achieve such cost savings, delivery of care to large groups of patients must be consistent. In this regard, consistent delivery of care requires detailed documentation for each patient and periodic monitoring of each patient to evaluate patient progress.
Consistent delivery therefore requires a definitive plan to enable healthcare providers to provide high quality care. Such a plan optimizes delivery of care, results in quicker patient recovery, helps to eliminate unwanted and undesired interventions. In short, such a plan is designed to achieve the desired goals for a patient.
Thus, for any given medical condition, to achieve cost saving reductions there must be uniform and consistent delivery of healthcare; measurable objective documentation; and detailed standard of care procedures.
One attempt at achieving the consistent standard of care and the provision of detailed documentation by the healthcare providers has been to develop a pre-printed critical care path document or form which incorporates predefined hospital standard of care procedures, care provider orders and expected outcome results for a given diagnosis.
While such critical care flow forms may have helped to improve patient management and improved system utilization to a certain degree, such critical care flow sheets have not proven entirely satisfactory. In this regard, the typical preprinted critical care path document for any given diagnosis is a document which is very difficult to use and to read. It contains a large number of small-sized time-line spaces for entry of the patient deviation codes for each day of treatment, or for each stage of patient care. Such small spaces result in small handwritten entries which can be illegible, or which can lead to an unwanted and undesirable transcription error of some type.
The entry of only code information requires utilizing another form for entry of the deviation information. The description of the deviation or other desired information as an explanation of the simple code information entered on the care path sheet, must be entered on other sheets of paper. Thus, not only unwanted and undesirable transcription errors can result, but also all necessary patient information is not available on a single document. Instead, multiple forms must be employed for entry of code information and text information.
Still yet another problem associated with preprinted critical care path flow sheets is that the preprinted critical care path flow sheets are configured for a single diagnosis activity only, such as a treatment plan for a patient undergoing hip replacement surgery. In this regard, if a patient is confined to a treatment facility and requires treatment for two or more surgical activities, or if a secondary diagnosis arises, such as where a surgical patient subsequently develops a medical problem, such single critical care path forms cannot be used. The preprinted forms do not have sufficient space to permit the addition of other care paths for multiple diagnoses. Moreover, if two or more single diagnosis forms are used, conflicting treatment plans may result. More particularly, pre-printed forms are not necessarily detailed enough for a given patient. For example, a patient involved in an automobile accident nay have a broken arm, require surgery to stop internal bleeding, be a diagnosed diabetic, require a hip replacement and develop secondary pneumonia two days after admission for treatment. Each diagnosed problem, in turn, could result in a multiple number of deviations. In short, because of the large number of permutations and combinations the use of multiple flowsheet documents greatly decreases efficiency.
Therefore, it would be highly desirable to have a new and improved clinical information system which can facilitate greatly the development and execution of a patient care plan, even where there exists multiple clinical diagnoses whether medical, surgical or a combination thereof.
Therefore, the principal object of the present invention is to provide a new and improved method and apparatus for facilitating the implementation and execution of clinical critical care path information for patients.
Another object of the present system is to provide such a new and improved method and apparatus which can assist healthcare providers in implementing and executing such plans where multiple diagnoses exist or occur subsequent to the commencement for a treatment plan for a single diagnosis.
Briefly, the above and further objects of the present invention are realized by providing a new and improved clinical critical care path system, which can be tailored readily for a given patient diagnosis for either single or combined medical and/or surgical diagnoses.
The clinical information system stores critical care information for various patient diagnoses and retrieves them for a given patient. Treatment information is tailored to a given patient by enabling selected treatment information to be edited. Where multiple diagnoses are present, the prescribed or ordered treatment plans for each diagnosis are merged for a given patient, and potential conflicts are determined for any ordered activity. Upon determination of a conflict, patient treatment information is repeated on separate display lines to alert the healthcare provider to permit the healthcare provider to analyze the conflict and to determine what order or orders should be entered. Customized multiple diagnosis treatment information can then be entered and stored for a given patient.